The hospital's name translates from Dutch as "Great Barn," an inheritance from the Groote Schuur estate that the Dutch East India Company laid out as a granary in the seventeenth century. The hospital itself was founded in 1938 on the slopes of Devil's Peak, the dramatic shoulder of the Table Mountain massif. It became the chief academic hospital of the University of Cape Town's medical school, providing advanced care and training in every major branch of medicine. The setting is striking - a hospital built into a mountainside, its buildings stepping up the slope with views across the Cape Flats to the distant Hottentots Holland mountains. The N2 highway, merged with the M3, curves around the hospital in a massive ten-lane bend that Capetonians simply call Hospital Bend.

Barnard had spent years preparing for the transplant, experimenting with over fifty dogs in the hospital's animal laboratory to perfect the surgical technique. He was not the only surgeon racing toward this goal - Norman Shumway at Stanford had developed many of the procedures Barnard would use - but it was Barnard, at Groote Schuur, who got there first. The surgery began late on the evening of 2 December and ended in the early hours of 3 December 1967. Washkansky survived the operation and lived for eighteen days before dying of pneumonia, his immune system weakened by the anti-rejection drugs. The brevity of his survival did not diminish the achievement. Barnard had proved that a human heart could be transplanted from one person to another, that the surgical barriers were surmountable. The medical era of organ transplantation had begun.

The first heart transplant took place in a country where the majority of the population was denied basic political rights, where hospitals were segregated by race, and where access to advanced medical care depended largely on the color of your skin. Groote Schuur Hospital operated within this system even as it achieved its greatest triumph. The donor, Denise Darvall, was a young white woman. The recipient, Louis Washkansky, was white. Barnard's brother Marius, also a surgeon on the transplant team, later became a politician who opposed apartheid. The hospital itself was declared a Western Cape Provincial Heritage Site in 1996, two years after the end of apartheid, recognizing both its architectural significance and its role in medical history.

Groote Schuur remains one of South Africa's foremost teaching hospitals, known particularly for its trauma unit, anaesthesiology, and internal medicine departments. It employs over 500 doctors, 1,300 nurses, and 250 allied health professionals, and attracts visiting medical students and specialists from around the world. The old main building, where Barnard performed the transplant, now houses academic clinical departments and the Heart of Cape Town Museum, which preserves the actual operating theatres where the surgery took place. In 1984, two new wings were added to accommodate the hospital's expanding role. The institution that began as a colonial granary estate has spent nearly nine decades as a working hospital, its reputation built on one extraordinary night in 1967 and sustained by the daily work of saving lives that continues on Devil's Peak.